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Tumor markers in finding recurrent disease in colorectal cancer: a diagnostic review

机译：在大肠癌中发现复发性疾病的肿瘤标志物：一项诊断性评论

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Aim: In the search for evidence-based follow-up of patients after resection for colorectal cancer, numerous tumor markers have been proposed. This review has evaluated these markers and comments on the diagnostic accuracy in finding recurrent disease in relation to Carcino-Embryonic Antigen (CEA). Methods: A comprehensive literature review (1985-2010) was performed by two independent reviewers. Sensitivity and specificity of markers mentioned in the articles were checked by recalculation. A validated quality score system was used to estimate study quality. Results: Seventeen studies focusing on eight different markers were included. Three markers were shown to have comparable or better accuracy than CEA: TPA, CA 242 and CA 72-4 in at least one study. These three markers, from four independent studies, showed a tumor marker sensitivity of 60% in combination with an outperformance of CEA in follow-up. These results were not confirmed by six other studies investigating the same markers. Conclusion: This review revealed three tumor markers other than CEA that have been shown to adequately indicate recurrences in colorectal cancer. However, comparability of studies was difficult. Therefore a prospective study of these markers seems necessary to investigate their real value, and to overcome design and inclusion biases.
机译：目的：在对结直肠癌切除术后患者进行循证随访时，已经提出了许多肿瘤标志物。这篇综述对这些标志物进行了评估，并就发现与癌胚抗原（CEA）相关的复发性疾病的诊断准确性进行了评论。方法：由两名独立的评审员进行了全面的文献综述（1985-2010年）。通过重新计算检查了文章中提到的标志物的敏感性和特异性。经过验证的质量评分系统用于评估研究质量。结果：包括针对八个不同标记的十七项研究。在至少一项研究中，显示出三种标志物具有比CEA相当或更高的准确性：TPA，CA 242和CA 72-4。来自四项独立研究的这三个标记物显示，肿瘤标记物敏感性> 60％，且在随访中表现优于CEA。其他六项研究相同标志物的研究并未证实这些结果。结论：这篇综述揭示了CEA以外的三种肿瘤标志物，这些标志物已被证明足以表明大肠癌的复发。但是，研究的可比性很困难。因此，有必要对这些标记物进行前瞻性研究，以调查其真实价值，并克服设计和包含偏见。

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